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Short-Term Memory and Aging, 2008.
A discussion of the possible causes for short-term memory loss in old age.
2,550 words (approx. 10.2 pages), 11 sources, APA, £ 46.95
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Abstract
This paper addresses short-term memory loss among the elderly. The paper points out that the habit of viewing difficulties of short-term memory loss as normal in aging is countered by knowledge of the phenomenon as a frequent indication of changes in other memory functions. The paper mentions current models, which address short-term memory in relation to brain connectivity, such that impaired short-term memory may be read as a sign for other alterations in memory or brain function that are more significant. The paper looks into a variety of causes in order to gain a better conceptualization of a condition that is a frequent symptom, rather than a disorder all its own. The paper concludes that symptoms involving cognition and memory indicate something, and are not reducible to old models of steady decline, especially mental decline, in old age.
From the Paper
"An aging North American population and much research attention given to Alzheimer's and dementia have produced considerable knowledge of help in understanding other conditions of brain function including mental and nervous disorder. Grady, Furey Et Al (2001) examined altered brain connectivity and the decline of short-term memory of a sample of Alzheimer's patients and a normal control group. Alzheimer's disorder is increasing defined as a syndrome of dysfunctional connectivity within the brain whose most apparent indication is often much impaired short-term memory. Given the technology available to neurologists and neuro-psychiatrists of today, much more is understood of what happens to the memory of the Alzheimer's patient in addition to knowledge allowing us to know more of the normal or aging person who does not present the condition. Delays in cognitive processing due to Alzheimer's changes affect other aspects of memory. For instance, impairment in the functioning of the prefrontal cortex of means the patient cannot recognize a once familiar face, or the face of a caregiver or other individual that is seen daily."
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Canadian Bush Pilots and Air Medical Services, 2008.
A discussion of bush pilots and the advent of air medical services in Canada.
2,290 words (approx. 9.2 pages), 13 sources, MLA, £ 42.95
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Abstract
This paper examines the rise of air medical and evacuation services in northern and remote areas of Canada after the 1920s, noting the continuing need for air ambulance services for Canadians living beyond road or rail networks. The paper points out that a great array of popular history material has been published in the last thirty years or so attesting to the romantic lives of bush pilots who indeed were often self-styled persons to occupy their own boundless milieu. The paper adds that a study of the many female bush pilots provides an intriguing aside on the women's history emphasis of the last decades that can lend an impression of women's domesticity that was by no means general. The paper concludes that, today, bush pilots retain their particular glamour, being well-equipped and trained with every benefit of modern communications and navigation, and still risking unusual, even ridiculous situations.
Outline:
Introduction
A Twentieth-Century Progression
Medical Services in Northern Canada
Saskatchewan
Training of Pilots and Medical Staff
Concluding Discussion
From the Paper
"With socialized medicine as a federal Canadian addition, outpost infirmaries and hospitals were incorporated into local communities but some memoirs refer to occasional doctors who carried on in remote service, radioing instructions to particular flying companies or pilots; instructions arrived via Royal Canadian Air Force stations, too, in a continuing range of services that has by no means subsided with the advent of tele-medicine. Nursing were sometimes found in contract posts who might be better described today as physician's assistants in their obstetrical and orthopedic skills, not a few of them turning to surgery where there was no doctor and air evacuation impossible in time to save lives. (Larmour 1988) The international profession of nursing took considerable interest in the post-World War II decades in what Canadian provinces and territories were beginning to pioneer in nursing stations, infirmaries, public information on when to bring patients to radio dispatch centres and all else done and learned by practitioners in the course of northern or Arctic service. (Waller 1964, King 1968, Smith 1972)"
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Finance and Management: Non-Profit Organizations, 2008.
An examination of the profit measure criterion for governance at non-profit organizations.
1,205 words (approx. 4.8 pages), 4 sources, APA, £ 24.95
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Abstract
This paper examines non-profit organizations, focusing particularly on profit measure criterion, and argues how it can benefit a hospital facility grappling with high costs and high expectations. In so doing, the paper looks at several of the broad characteristics that define non-profit organizations and suggests how an effective policy governance model and health care provisioning can be achieved simply by paying attention to the bottom line. The paper concludes that hospitals must understand that they have finite resources and that offering a few core services at a high level is infinitely preferable to running up a high debt offering numerous services at a low level.
From the Paper
"One of the strengths of using the profit measure approach is how it can succeed in ensuring that there is no confusion about who does what, what is expected when they do it, and what the final outcome(s) should be. According to Carver & Carver (2006), the properly-functioning Policy Governance Model will accentuate the following: self-imposed rules (for the board) vis-a-vis the delegation of authority and the method by which "board-stated" criteria will be utilized during the evaluation process; clarity in terms of who is responsible to whom; and a determination to see to it that board decisions (while open to possible change) are never undermined. While Carver and Carver do not touch upon it, the preceding governance approach clearly functions best when there is one easily quantifiable, easily transferable, means of measuring who is performing and who is not performing across the whole breadth of the organization's activities. The profit measure obviously does this and thereby sees to it that long-term goals are not compromised by short-term mismanagement in one department (or group of departments)."
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Life-Support Withdrawal, 2008.
A research proposal for a study of how families deal with making end-of-life care decisions.
2,370 words (approx. 9.5 pages), 10 sources, APA, £ 43.95
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Abstract
This research proposal involves an examination of how the decision to remove life-sustaining interventions in the intensive care unit (ICU) comprises a most significant event that encapsulates diverse experiences for families. The methodology used consists of a sample of four to five families who will be contacted through ICU family conferences in one or two hospitals. The research design is based on interpretive phenomenology, according to the work of M. van Manen and its focus on direct experience. The paper maintains that family members' experience of decision making related to withdrawal of life support is subjective, but also universal in many respects. The decision to withhold or withdraw interventions involves a complex process that occurs in stages. The paper concludes that the goal of the study is to show how this process is either facilitated or made more problematic for families.
Outline:
Introduction
Research Design
Theoretical Underpinning
Strengths and Limitations of Design
Participant Selection
Study Setting
Data Collection
Data Analysis
Steps to Ensure Rigor
Dissemination of Findings
Conclusion
From the Paper
"The theory underlying this study ultimately is found in the writings of Heidegger (1975, p. 11) who maintained that the individual worldview is not relative because whenever a worldview is developed, what it contains "can be formulated in propositions and rules which are related in their meaning to a specific really existing world". Individual experience, then, reflects universal experience. According to Phillips and Brown (1993), a critical hermeneutic approach proves useful in investigating the management of meaning. The approach is based on hermeneutics as an area of philosophy which relates to the theory and practice of interpretation, but is critical because it enables self-conscious reflection on social conditions. When the hermeneutic perspective is combined with a critical approach, the result is a structured approach to the analysis of the role of meaning in people's experience (Phillips & Brown, 1993). Researchers use the approach to associate ideas and symbols in ways which will explain the creation or maintenance of a permanent pattern of social relations. These include any activity which affects the network of symbols through which the individual or group understands reality. Critical hermeneutics is especially useful since it extends existing interpretive approaches (Phillips & Brown, 1993). The method can be used in longitudinal studies, in studies comparing cultural management, or in the study of groups and inter-group conflict."
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Drug Addiction in Professional Nursing, 2008.
This paper explores chemical dependence in nurses and its implications for the nursing profession.
2,008 words (approx. 8.0 pages), 9 sources, APA, £ 38.95
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Abstract
The paper examines the biological and psychosocial prerequisites for substance abuse and subsequent addiction in nurses. The paper then looks at the treatment programs available as well as the preventative measures in place. The paper also discusses the implications of substance use, abuse and subsequent dependency for present and future nursing practice.
Outline:
Introduction
Position
Predisposing Factors
Treatment
Prevention
Implications
From the Paper
"In order to understand fully the pathogenesis of addiction, the biological and psychosocial prerequisites for substance abuse and subsequent addiction will be discussed. The pathogenesis of substance dependence conforms to a general behavioral pattern of cause and effect. An external stimulus such as stress in multiple spheres of an individual's life (e.g. work/school, home, personal) may trigger an initially behavioral response to these stressors. The pleasurable stimulation from intake of these substances, the escapist theme, and the aversiveness of the "reality" of the individual's situation conditions the individual to avoid the aversive stimulus and take in these substances, where their pleasurable effects serve as a reward, a positive reinforcement for substance-seeking behavior. Behaviorally-oriented treatments involve extinction of this reinforcement."
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High Turnover Rates in Emergency Department Nurses, 2008.
A discussion of the growing shortage of emergency department nurses.
3,530 words (approx. 14.1 pages), 21 sources, APA, £ 59.95
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Abstract
This paper focuses on the high turnover rates among emergency department nurses. In particular, it takes a look at leadership and management issues within an emergency department at a community-based hospital in a mid-size US city. The paper points out that the nursing shortage is not simply a problem of supply and demand, but much the result of high attrition rates due to work dissatisfaction, a phenomenon that was almost unheard of in older nursing staff, in spite of the use of incentives to retain workers. The paper suggests that the multi-generational composition of the work force needs to be addressed and that each generation's strengths and weaknesses should be assessed. The paper concludes that, once intergenerational differences and needs are recognized, acknowledged, appreciated and addressed - not only at the managerial level but also in the workplace - increased job satisfaction and increase in ranks may reverse the current trend.
Outline:
Introduction
Literature Review
Causes
Solutions
Reflection
From the Paper
"From these scenarios, it can be seen that a "culture" that adheres to an unspoken, strict hierarchy exists within the emergency department, almost akin to a tradition. To the nurses that have been with the department for some time, it was an efficient system that accomplished tasks according to ability and experience. This is evident in the lack of clout juniors have within the department, who are relegated to "scutwork" and rarely get to participate in more engaging activities in the emergency department. Very rarely did any junior staff stay long enough to reach at least 18 months. Coincidentally, the hiring of fresh graduates was only implemented two years ago."
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Learning Evidence - Parse's theory, 2008.
An account of Parse's human becoming theory.
1,327 words (approx. 5.3 pages), 5 sources, APA, £ 26.95
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Abstract
This paper deals with Parse's human becoming theory as a means for providing structure for ways of thinking and being with patients, as they create their own quality of life. The author draws upon his own life experience and suggests implications for the use of the theory in nursing practice. The paper appends a copy of William Ernest Henley's poem, "Invictus".
Outline:
Life Experience
Definition/Description of Hope
Content Acquired through Concept Clarification Process
Hope in Relation to Parse's Theory
Implications for Nursing Practice
From the Paper
"Parse's theory of human becoming theory is a means for providing structure for ways of thinking and being with patients as they create their own quality of life. Human becoming theory is concerned with lived experiences of health (Kelly, 1999). The holistic approach is essential since lived experience, meaning, and understanding all form various aspects of the unitary process of human life (Kelly, 1999). Parse's concepts guide nursing for being present with the patient as they illuminate meaning, synchronize rhythms, and co-transcend with the possibles. Hope is based in these possibles: the person is moving beyond the present toward the unknown. My life experience will illustrate how Parse's theory helps the person to maintain hope and to achieve transformation. For Parse, the central idea is that the person is expert for their lives and they always have choices. The person is involved in a search for meaning and is capable of achieving transformation."
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Plan of Care for an Elderly Patient, 2008.
An assessment of an elderly patient suffering from constipation, incontinence, and urinary tract infection, and a proposed plan of care.
740 words (approx. 3.0 pages), 3 sources, APA, £ 15.95
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Abstract
This case study analyzes the health problems of an elderly patient that mainly involve constipation, incontinence, and urinary tract infection. The paper points out that these problems are very common among people over 65 years of age. The study proposes that the patient be provided with a program of good nutrition and health teaching by qualified nursing staff. The program will also require regular check-ups. The paper concludes that the successful implementation of this program should help to eliminate the patient's problems.
Outline:
Introduction
Analysis of Data
Assessment
Plan of Care
Nursing Orders
Implementation
Evaluation
From the Paper
"For older adults, if the food plan is going to meet nutritional needs, it must account for changes related to aging (Collis, 2002). Joan must receive enough calories per day to meet her needs for protein, calcium, iron, and vitamins. Because of the presence of the pressure sore, Joan needs protein to allow the sore to heal. Protein also is needed to build and maintain muscle and tissues (Collins, 2002). Because of such serious problems with constipation, Joan most especially needs a high amount of fibre in her diet. She can obtain fibre from such foods as bran products, raw fruits, prunes, and whole grain breads and cereals (Kozier, et. al., 2000)."
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Health Care Costs, 2008.
A discussion of the rising costs of health care in the United States.
1,050 words (approx. 4.2 pages), 6 sources, APA, £ 21.95
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Abstract
This paper takes a look at the reasons health care costs continue to rise in the United States. It points out that many factors interact to increase costs and these factors include certain elements that, ironically, are thought to reduce costs or that may have been intended to reduce costs. The paper adds that costs increase in part for natural economic reasons, such as the cost of developing new drugs, or the added costs accruing due to the creation and implementation of new medical technology. The paper maintains that one of the primary reasons fo cost increases is that the public does not pay for what it uses in medicine, meaning that people do not pay directly out of their own pockets. Instead, millions have their costs paid by insurance or a company health plan, and this increases the overall costs. To conclude, the paper calls for a better and more certain analysis of how costs could be reduced.
From the Paper
"The patient may pay something on his or her bill, but it is usually only a part of the whole. Alterio (2007) notes how some of the efforts to control costs can harm patients, which in turn increases health care costs over time because patients may have to wait longer for treatment and need more medical attention when they do get it. Alterio notes that keeping down costs in HMOs often means requiring doctors to see more patients per hour and to give each patient less time, which saves money in the short-term while increasing costs in the long run."
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DVT and the Elderly, 2008.
A look at the most appropriate non-medical nursing intervention to prevent the incidence of deep vein thrombosis (DVT) among surgery patients through a review of three artices.
1,095 words (approx. 4.4 pages), 3 sources, APA, £ 22.95
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Abstract
Graduated compression stockings are widely used to prevent deep vein thrombosis (DVT), but their use in clinical practice is variable and is usually not as effective as research suggests. This paper discusses the most appropriate nursing intervention to prevent the incidence of deep vein thrombosis among postoperative elderly patients with hip fracture by reviewing three articles consisting of quantitative, qualitative, and systematic research. Using specific criteria to assess each article, the paper determines which article is the most useful.
Outline:
Relevance and Significance
Summary of Evidence
Research Problem
Purpose
The Studies
Qualitative
Quantitative
Systematic
Implications for Practice
Strategies to Change Practice
Appendix A
Appendix B
From the Paper
"The American Nurses Association (2006) conducted a systematic study where the focused research question was: Are graduated compression stockings effective for the prevention of DVT? The criteria were that definite conclusions about effectiveness had to be possible. The criteria were appropriate and clear since samples had to be large and below-knee stockings evaluated. It is not likely any relevant studies were missed since the research was done by the American Nurses Association (2006) to guide practice. The validity was carefully appraised to the extent that all the studies were discarded. The results were not similar. They were divided into two groups: stockings versus no stockings and stockings combined with another preventive measure. It was the difference between studies that caused the problem. "
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General Electric and Amersham, 2008.
A discussion of General Electric's acquisition of Amersham.
1,130 words (approx. 4.5 pages), 5 sources, APA, £ 23.95
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Abstract
This paper takes a look at the acquisition of Amersham by General Electric Corporation. It points out that Amersham is a major competitor in the healthcare industry and the acquisition was completed in 2004. The review is taken from the perspective of Amersham, the target enterprise. The paper also discusses an article that reviews Sarbanes-Oxley legislation and its effect on technology enterprise business culture.
Outline:
Target Overview
Amersham's Perspective
Acquisition Outcome
Conference Activity
Sarbanes-Oxley & Its Implications
Effect on E-Commerce
Sarbanes-Oxley Measures
From the Paper
"In the year prior to the completion of the acquisition of Amersham by GE, the company began to reassert itself within its market segments. To do this Amersham increased its research and development (R&D) expenditures by 18% and prepared to launch numerous new products in the two years following the acquisition (Amersham, 2004). This investment in future technologies and products is further evidence that Amersham not only viewed the combination of Amersham with GE as an overall positive but intended to capitalize on GE's wider market reach and accessibility to a greater variety of sub-markets. These moves indicate the company's executives were forward planning their corporate and business level strategies based on integration into GE Healthcare which is where Amersham would be situated. Additionally, because of efficiencies gained by being integrated into its new parent corporation, Amersham expected to be able to reduce its operating costs by as much as $100m without incurring substantial personnel layoffs and reductions (GE, 2004). These outcomes all affirm the astuteness of this acquisition and that Amersham itself recognized the strategic importance of combining with GE rather than competing directly against it which would have been unsustainable in the long-term."
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Quality of Life Nursing Care, 2008.
This paper discusses quality of life issues that support Canadian patients with terminal disease through a review of five articles on the topic.
2,275 words (approx. 9.1 pages), 5 sources, APA, £ 42.95
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Abstract
This paper explains that, even with intervention and assessment, and to some degree intra-observer variation, quality of life may not be enough to define a patient's contentment with life when faced with end of life issues. The author points out that life-changing events and end of life issues can be so sudden that a patient and her family may find control over their lives involuntarily wrenched from them. The paper cites that the transcendence theory can be a powerful motivator to achieve health care objectives for helping bereaved patients, their families and their nurses "move on" to understanding how suffering and changes can affect new individual insights. The author relates that, in caring for the older adult, it is sometimes more understood than appreciated that they may have more complaints to attend to, more symptoms that they complain of and may even be difficult to approach. The paper then independently reviews five different articles on this topic.
From the Paper
"The second article tells of the triumph of the human spirit over seemingly impossible odds (McLean, 2006). In spite of his diagnosis of terminal colon cancer, firefighter lieutenant Mark Johnston underwent surgery in spite of the bleakness of his condition. What was remarkable was the camaraderie of his fellow firefighters, who would do what seemingly meant little more than keeping vigils with him. When Mark went into relapse after rejoining his team a year after, a testament to his spirit, he dispelled the prevailing myth of the palliative care unit's reputation for admitting patients that do not get discharged. In spite of this, Mark sought admission hesitantly at first, but with the constant show of support by family and friends during his times of greatest need and pain, he was able to eventually - and dramatically - return home."
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Cesarean versus Planned Delivery at Term, 2008.
This paper discusses the article "Maternal Mortality and Severe Morbidity Associated with Low-risk Planned Cesarean Delivery versus Planned Vaginal Delivery at Term" by Liu, Shiliang, Liston, Robert M., Joseph, K.S., Heaman, Maureen, Sauve, Reg,
750 words (approx. 3.0 pages), 1 source, MLA, £ 15.95
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Abstract
In this article the writer reviews the scholarly article, "Maternal Mortality and Severe Morbidity Associated with Low-risk Planned Cesarean Delivery versus Planned Vaginal Delivery at Term", about the relative dangers of cesarean section versus vaginal delivery for women. The paper looks at the purpose of the study and summarizes the results. The writer then describes its strengths and weaknesses and outlines how such findings should be utilized in the future. In addition, two key questions that should guide future investigation are enumerated.
Outline:
Abstract
Purpose of the study
Results of the study
Strengths of the study
Weaknesses of the study
How to use these findings in practice
Two questions for future research
From the Paper
"The strengths of the study lie in the fact that few studies this writer has reviewed have been more comprehensive. To wit, the planned cesarean group comprised 46,766 women; for the planned vaginal delivery group, the figure was 2,292,420. Every bit as importantly, the study is longitudinal in nature. Specifically, the study encompasses a 14-year period - a length of time seemingly sufficient to ensure that curious aberrations or anomalies in particular years did not cause fundamental distortions in the findings of the study. Additionally, to ensure the validity of the data findings, the researchers employed adjusted odds ratio and confidence intervals; as well, the authors used multivariate analysis to control for "confounding variables" such as age, year of delivery, and elderly primigravidity - among other factors."
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A Nutritional Health Treatment Assessment, 2008.
A case study which assesses a particular elderly patient's health problems and suggest an appropriate plan of care involving better nutrition.
730 words (approx. 2.9 pages), 3 sources, APA, £ 15.95
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Abstract
This case study analyzes the health condition of elderly patient Joan, suffering from severe pain when having a bowel movement. In this study, nutrition forms the main element in the plan of care. Following a close analysis, the study concludes that all of Joan's problems are related to inadequate nutrition and therefore can be managed best by a program of nutrition.
Outline:
Analysis of Data
Nursing Diagnoses
Plan of Care
Implementation
Evaluation
From the Paper
"Joan needs social support. Her son should be encouraged to eat meals with her whenever he can. He is the best one to encourage her to eat, and staff can reinforce that encouragement. Nurses will push fluids as hot fluids, fruit juice, and prune juice. The dietician needs to be informed of the problem with constipation and the pressure sore. Joan's diet will provide her with adequate nutrition and will be high in fiber. For the first period, Joan's diet and fluid intake should be monitored to make sure that she is receiving the nutrients she needs. Nurses will provide Joan will the needed health teaching about the need for proper nutrition, fluids, and information to eliminate her urinary tract infections. Joan's son can also remind his mother of this information."
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